I am an Occupational Therapist, and often get asked to Explain what an OT does. Over the years I have met and worked with hundreds of people with an interesting range of injuries, conditions and disabilities, both physical and psychological. The purpose of this blog is to share interesting case studies and anecdotes from my experience (confidentially of course) to help explain what an OT does.

Tuesday, July 14, 2009

A *#(*T#! Dream Come True

Before I studied OT, I did an undergraduate degree in Psychology. My favourite subject by far, was one called Abnormal Psychology. Within this subject, I learned all about the more 'interesting' psychological disorders, such as Munchausen's By Proxy and Tourette's Syndrome.

Tourette's particularly fascinated me. Not only because it would be hilarious to see, but because I was really interested in the neurological processing going on to cause the compulsive verbalisations and tics. It is a little understood condition and one that still baffles the medical world.

I was employed for a time, to assess people who had a range of physical and psychological conditions, and report on the type of work they may be able to perform.

A work colleague of mine had excitedly announced one day that she had just assessed a man who had Narcolepsy. I was insanely jealous. He had apparently fallen asleep at the table in front of her. Opportunities like that don't happen too often. It was with great joy then, that I discovered that soon after, I was to assess a man who had Tourette's Syndrome.

When I read the referral information, I was both excited and terrified. I was so worried that I would not be able to maintain composure and that I would either ask inappropriate questions, or not be able to speak at all. I did as much reading as I could to understand the condition and when the day arrived, felt as prepared as much as I could be.

On the morning of the appointment, I was summoned to reception and advised that the client was outside the waiting room. His wife had come to reception and declared that he could not come through the front door. I walked outside and found a tall, middle-aged man with his similarly aged wife, standing there, both looking rather anxious.

I was told by the wife, that her husband was nervous and could not speak at all. I offered to conduct the interview standing right there. I had determined his work capacity immediately (he had none), and decided to direct my questions at the wife, to determine if they needed any additional support.

The woman told me this story.

Her husband was a fully functioning, normal man. He had a well paying job in an administrative position and enjoyed life. One day, he woke up and could not speak. Suspecting a stroke, the woman rang an ambulance. Over the next few days, he underwent scans and neurological assessment, but no abnormalities were found. Over weeks, the man was assessed and after showing no signs of improvement, he was sent home. Over time, he began to experience tics - jerky involuntary movements, and demonstrated extreme anxiety when faced with leaving the home. When he did speak, he stuttered, and his words were often accompanied by expletives. He could not work. He could barely function. Getting to the appointment was a massive achievement for the couple, which had taken days of preparation.

During this conversation, I forgot to be awestruck or amazed that I was actually standing next to a person with Tourette's. I forgot to be awkward and giggly. Because I wasn't.

I felt sad for this man and this woman, who had been suddenly and without any known reason, plunged into hell by this awful condition. As I spoke to them, I asked about their support network, resources and other treatment options that could be explored. I wanted to help. In my report, I suggested that the couple be given as much support as possible to access counselling, therapy and specialists that may down the track, be able to help.

It was a dream come true, to meet a man with Tourette's, but I didn't need to suppress giggles or hide my amusement. Because it wasn't funny. I thank that couple for sharing their story with me and for teaching me more than I could have ever imagined.